Does 'Cancer Moonshot' Launch the Right Message?

Brandon Cohen

Disclosures

February 11, 2016

Countdown to a Cure?

During President Barack Obama's final State of the Union address, he outlined a new initiative to cure cancer. Led by Vice President Joe Biden, the program is described as a moon shot, a name chosen specifically to evoke images of the successes of the US space program. At the same time, it suggests that the ambitious project is fraught with difficulties. A recent Medscape article on the subject prompted lively debate, with some ardent supporters of the plan duking it out with staunch naysayers.

More than a few respondents' doubts stemmed from what they saw as conspiracy in the way large institutions have dealt with cancer. One physician tested the waters of paranoia while still maintaining a drop of hope:

The costs of some of those treatments makes one stop and wonder why would you want to stop your own gravy train? I like to think most people have had their lives touched personally by cancer so as to never engage in intentionally manipulating the chemo drug market or suppressing information that could lead to significant reduction in the number of cancer cases per year. Maybe I'm being too optimistic about my fellow man.

Another physician went a step further, seeing only dark forces at work: "The cure for cancer has been around for years but greed and bureaucracy have not allowed further progress."

Others shot this attitude down as ugly demagoguery. One healthcare professional wrote:

As for those who believe that there is a conspiracy to not allow cancer to be cured, you are insulting the work of thousands of researchers who have made progress using a scientific methodology of testing hypotheses to allow for incremental increases in a body of knowledge. Science is not an all-or-nothing task.

A primary care physician was concerned about the cost to patients of the new initiative: "I hope the cures don't cost a lifetime of wages for a few years of life. If the government sponsors it, the cures should be free."

But an optometrist made a very different economic evaluation: "The government should stay out of this sort of business and many others that the private sector can operate much more efficiently and cost-effectively!"

Should We Shoot for Prevention Instead?

Several respondents saw the language of the declaration as a cause for concern. One healthcare professional wrote:

I am appalled by the simple-minded and atavistic perspective that cancer cures come from engineering projects and that there is some comparison to be made to space travel. . . . The challenge of the actual moon shot was not ignorance of the subject at hand. The challenge of cancer research is indeed ignorance of the subject at hand. Referring to any aspect of scientific investigation as a moon shot reveals a deep misunderstanding of science.

A doctor concurred and added:

Biden's moon launch feeds into too many wrong approaches to cancer itself: (1) Cancer is thought of as a single entity; that distracts from its complexity, and (2) It very much distracts from the idea that prevention is the ultimate cure, and we should be spending more money on education of that idea rather than the billions of dollars and time on discovering, marketing, selling expensive medications that buy little time and less quality of life.

Another physician picked up the cause of prevention:

Our government and society need to take a closer look at our tainted food supplies. I believe that what we eat has much to do with the sad state of health in our country, all leading to high rates of obesity, cardiovascular disease, diabetes, sleep apnea, and cancer. We are what we eat! If we all learn to eat healthier, have better food choices, and take some responsibility, I suspect that health issues and cancer rates will decrease.

But some found the focus solely on prevention to be deeply flawed. One healthcare professional wrote:

Some people have cancer already, and some have engaged in lifestyle behaviors that have put them at risk of developing cancer in the future. Should we abandon the efforts to find a cure and focus on the healthy and promote health education only?

One physician was guardedly optimistic, seeing more attention and more money as positive developments:

As for Vice President Biden's moon launch, such attention can only help. We should welcome it. Attention usually brings more funds and occasionally a dedicated independent funding source or two.

Houston, We Still Have a Problem

This healthcare professional had no objections to the plan in theory but questions its efficacy:

If throwing more money at the NIH will find a cure for cancer by 2020, I'm all for it. But I'll be willing to bet that if you post this comment again in 2020, you will find that cancer rates have stayed the same or even gone up - just like they have over the 5 years from 2010 to 2015.

Another doctor commented on the counterintuitive potential for the specificity of the research to work against its stated goals:

President Obama, while well-intentioned, is forgetting that most medical advances have been made in laboratories doing basic research (biological, biochemical, physiological) instead of the labs that were looking for cures for particular diseases. Most of the latter have wasted years of work and billions of dollars. I wish he would fund basic research instead of cancer research.

The final word goes to a physician who took the discussion as an opportunity to draw an analogy and critique the political process in general:

Everyone wants to cure cancer, and after 30 years practicing medicine, one thing is certain. Cancer survival increases when competent doctors work as a coordinated team on the patient's behalf. If the President and Congress would apply this basic principal, and work together, the cancer in Washington would be cured and we would all be better off.

Full discussions of these topics are available online.

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